The objectives of this chapter are to describe the reported treatment modalities/interventions in different settings of treatment for adolescents with psychoactive substance use disorders (PSUDs). The development of the current state of knowledge concerning relations among patient variables, treatment characteristics, and environmental factors is discussed in light of the treatment-related politics of the era. Consideration is given to selection and planning of individualized treatment menus and review of updated treatment strategies, with special attention to the most commonly diagnosed comorbid psychiatric disorders. Present and future suggestions to decrease attrition and treatment failure and to improve treatment efficacy and aftercare are illuminated.